Tylenol or Advil? Not Created Equal for Pain Relief

By Sheryl Kraft

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As we move merrily along into our so-called midlife, it's not uncommon to feel pesky, everyday aches and pains from things like headaches, back pain, arthritis, sciatica … the list goes on.

Because I exercise pretty frequently, it's not unusual for me to feel pain from time to time (yes, I'll admit pushing myself beyond my reasonable limits every once in a while!). Granted, I can't always blame exercise—although I hate to use the age card to start complaining … so I won't.

One of my most recent and pleasant discoveries for pain management has been self-massage for various aches and pains; my favorite thing to use is a hand-held massager, like these made by Wahl.

But that's not always the only remedy. My medicine cabinet is filled with different over-the-counter pain relievers, among them Tylenol and Advil. And I usually reach for one or the other with no thought given as to why I'm taking that particular one, other than the fact I can no longer stand the pain I'm feeling, or I've run out of one or the other.

Which is why a recent article in the Wall Street Journal caught my eye: It's about how all over-the-counter pain relievers do not work interchangeably; apparently they work differently in your body, and they can have different side effects. What's good for a headache is not necessarily good for achy knees.

The article says: "Got a headache? Tylenol, or its generic version acetaminophen, might be your best bet since it comes with fewer side effects, many experts say. Inflamed elbow? Advil, whose active ingredient is ibuprofen, is likely to bring greater relief. And if you're trying to bring down a fever, either medication will probably work, although some studies have found Advil to have a slight edge."

Who knew?

Curious, I scoured the Internet for more info. And sure enough, you need to be selective when choosing which to take for what ailment.

The Cleveland Clinic pitted acetaminophen (Tylenol) against ibuprofen (Advil). They reported that Tylenol works better for things like headaches and arthritis, while you're better off with Advil for things like fever, pain and inflammation.

Although both medications are considered to be safe, the word "safe" has some caveats:

They can be toxic. Taking too much Tylenol can be damaging to your liver (and it may be permanent). Prolonged use of Advil can lead to kidney damage, heart attack and stroke.

They can have side effects: Tylenol's side effects are minimal, although it can, on rare occasions, cause potentially fatal skin reactions. Advil may give you severe stomach bleeding (as in ulcers), heartburn, gastrointestinal upset and/or constipation.

And it's important to know a few other facts:

Acetaminophen (Tylenol) is present in over 150 other products, including those used to treat coughs and colds, allergies, pain and sleep disturbances; always check labels for acetaminophen or APAP to avoid overdose. The new daily limit is 3,250 mg. of acetaminophen—that's equivalent to 10 regular or six extra-strength pills each day. If acetaminophen is present in multi-symptom products you take, include that amount in your daily total. And you should not take it if you have three or more alcoholic drinks a day.

Ibuprofen (Advil) should be avoided before and after heart surgery and should not be used if you have an allergy to aspirin, naproxen (Aleve) or other NSAIDs (non-steroidal anti-inflammatory drugs, like Motrin). The risk of bleeding is increased for those over age 60 and for people with ulcers. Be cautious, too, if you take steroids, blood thinners or other NSAIDs, or consume more than three alcoholic beverages a day.

If you need an analgesic often (like for treating a high fever or chronic pain), experts advise alternating doses of Tylenol and Advil, which can minimize side effects while providing greater relief.

And of course, if you experience any type of allergic reaction, stop taking the medication and seek immediate help.

An interesting aside: Two recent studies found that along with dulling your physical pain, acetaminophen might also dull your responses to emotional pain.

If all this information is deterring you, there are also other things you can do to treat pain. The American Pain Foundation lists some herbs for pain management:

For fibromyalgia: ginseng

For tension headaches and neuropathic pain: kava kava

For spasms and muscle cramps: valerian root

And don't forget some other, more or less obvious remedies for pain:

Avoid overdoing exercise (I should take my own advice!)

Rest if you are hurt; give your body time to heal. Yes, in certain cases, the body can do a great job at repairing itself.

Indulge in a massage; whether at-home or in the hands of a professional.